Hepatitis B and Vietnamese-Americans

A few short months ago, a friend of mine from high school passed away from liver cancer, leaving behind a wife and young daughter. He was only 38 years old. Before he died, my friend wanted to spread awareness about hepatitis B and its prevalence in Vietnamese-Americans and potential to turn into one of the most aggressive liver cancers.

What is hepatitis B?

Hepatitis B is a liver infection caused by hep B virus (HBV). It is transmitted when blood, semen, or other body fluids from a person infected with Hep B enters the body of the someone who is not infected – sexual contacts, sharing needles, syringes, drug-injection equipment, and mother to baby. Exposure to HBV often result in a self-limiting infection that can be asymptomatic or present as acute hepatitis, usually followed by immunity. However, in about 6-10% of those infected, acute infection turns into chronic infection. These chronically infected people can transmit the virus to others. Left untreated, 1 in 4 of those with chronic hep B can develop serious liver disease, including cirrhosis, liver damage, and liver cancer. Persons with HBV infection have a risk of developing liver cancer over 200 times greater than those not infected.

What are the symptoms of hepatitis B?

Symptoms of acute hepatitis B infection include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored bowel movements, joint pain, and jaundice. Most people with chronic infection do not have any symptoms.

There is currently no cure for hepatitis B. However there are treatments that can help reduce the risk of liver disease/cancer and prevent people from passing the infection to others. Some treatments include medications, injections, and liver transplant. Not everyone with chronic hepatitis B infection will need treatment right away. Your doctor will closely monitor your liver by lab work or imaging and make recommendations as necessary.

Why should I care about Hepatitis B?

According to the Centers for Disease Control, chronic hepatitis B affects about 1% of the US general population. That number jumps to 10% in Vietnamese men. In addition, Vietnamese men also have the highest liver cancer incidence of any ethnic group, 11 times higher than the rate among white males. Even though liver cancer can be due to other causes such as alcohol abuse, birth defects, and other liver infections, 80% of hepatocellular carcinoma (liver cancer) in Asian American is caused by hepatitis B.

Even though the prevalence of hepatitis B and liver cancer is high in Vietnamese-Americans, only 1/3 are aware of their chronic hepatitis B infection and increased risk of cancer. A 1992 California study found that only 24% of Vietnamese adults had been tested for HBV. Factors associated with low testing rate include the lack of regular source of care, lack of physician recommendations, not knowing that HBV can spread during childbirth, from mother to child.

Who should be tested for Hepatitis B?

According to the Centers for Disease Control and Prevention (CDC), the following people should be screened for HBV:

All people born in regions of the world with high or moderate rate of hepatitis B. This includes Vietnam.

All people born in US who were not vaccinated at birth and who have at least one parent born in a country with high Hep B rate

Household contacts and sexual partners of people with Hep B

High risk populations (people with history of tattoos and sexually-transmitted diseases, and homosexual men)

Screening for Hepatitis B is a simple blood test. This can be done at any clinics or doctors’ offices.

Image by skeeze. https://pixabay.com/en/users/skeeze-272447/. Accessed 16 Oct 2018.What should I do if I already have chronic HBV?

If you have been diagnosed with chronic HBV, please make sure you follow up with your primary care doctor or specialist at least once every 6 months to a year. Your doctor will do routine lab work and imaging studies such as ultrasounds to monitor your liver.

You should also avoid alcohol, reduce red meat intake, stop smoking, and make smart lifestyle choices.

Do yourself a favor and get tested. Protect your friends and families by encouraging them to get tested as well. Spread the word in the community and together we can improve the lives of fellow Vietnamese-Americans.

Ana Nguyen, MD, MPH

Dr. Ana Nguyen completed her Bachelor of Science at Baylor University in Waco, her Masters of Public Health at the University of Houston, and her Doctor of Medicine at Texas Tech School of Medicine. She completed her training at John Peter Smith Hospital in Fort Worth and Baylor Medical Center. Dr. Nguyen resides in Dallas, TX with her husband and two children and is currently taking care of the homeless population in Dallas via Parkland’s Homeless Outreach Medical Services.

Hepatitis B and Vietnamese-Americans

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